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Dr Anu Kaur MBBS,FRANZCOG
Specialist Obstetrician and Gynaecologist

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Hysteroscopic surgery

Hysteroscopy is the inspection of the uterine cavity by endoscopy with access through the cervix. it allows for the diagnosis of intrauterine pathology and serves as a method for surgical intervention (operative hysteroscopy)

Operative hysteroscopy is a minimally invasive gynecological procedure in which an endoscopic optical lens is inserted through othe cervix into the end metrial cavity to direct treatment of various types of intrauterine pathology.

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Indications
Abnormal uterine or heavy menstrual bleeding
Hysteroscopy is frequently used in the evaluation of abnormal uterine bleeding (AUB) or heavy menstrual bleeding (HMB

Submucosal leiomyoma ( Fibroids)
Hysteroscopic removal of submucosal fibroids is indicated if they are thought to be the etiology of AUB or infertility.

A hysteroscopic myomectomy can be offered for some Uterine fibroids.

Uterine polyps
Endometrial polyps can cause AUB and may also be implicated in cases of infertility. Studies indicate that hysteroscopic polypectomy improves fertility outcomes.
In addition, endometrial polyps in patients with risk factors for endometrial carcinoma have shown a propensity for malignant transformation.
Thus, the removal of polyps noted by diagnostic hysteroscopy or sonography is indicated.

Uterine septum
A uterine septum is the embryologic result of incomplete medial regression of the Miillerian ducts following fusion in the midline and may be incidentally noted by hysterosalpingogram (HSG), SIS, or pelvic MRI, or during the work-up of infertility or recurrent pregnancy loss.

Lysis of adhesions
Intrauterine adhesions (IUA), synechia, or Asherman syndrome is a result of obstetrical or nonobstetrical instrumentation of the uterus or infection of the urogenital tract. Uterine adhesions can lead to AUB, infertility, or RPL, and are diagnosed by HSG or SIS. Hysteroscopic resection is the standard treatment of symptomatic intrauterine adhesions

Removal of a foreign body
A retained intrauterine contraceptive device (IUD) is the most common uterine cavity foreign body encountered.